1084 NE 91 Terr (2)Date
PERMIT APPLICATION FOR MIAMI SHORES VILLAGE
Job Address � " /t � i ?/ 72:i../Tax Folio // a / 7c 2
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Legal Descriptio
Owner / t d
Owner's Address / d F- 4 ' E ? / ��
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Municipal #
Notary as to Owner and/or Condo President Date
My Commission Expires:
FEES: PERMIT "VIO ' RADON
on to // ABC z�/� 7L 4— Historically Designated: Yes
, ( -/ ! Phone
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Master Permit #
SS#
Competency #
Address
Z CZ -77
Phone
Ins. Co.
Contracting Co. — Address
Qualifier
State #
Architect/Engineer
Bonding Company Address
Mortgagor Address
Permit Type (circle one) ^ I DING EL PLUMBING MECHANICAL ROOFING AV G FENCE XCN
WORK DESCRIPTION .�.�5 /Cpl 1 To /a/ ° 2 $/ X oy/Ue. ,7-._ 4 .1 L -o� A % r
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WARNING TO OWNER: YOU MUST RECORD A NOTICE OF COMMENCEMENT AND Y UR FA IILURE 'TO DO SO MAY
RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY (IF YOU INTEND TO OBTAIN FINANCING
CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT.)
Application is hereby made to obtain a permit to do work and installation as indicated above, and on the attached addendum (if applicable). I
certify that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. I understand that separate
permits are required for ELECTRICAL, PLUMBING, SIGNS, POOLS, ROOFING and MECHANICAL WORK.
OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable
laws regulating construction and zoning. Furthermore, I authorize the above -named contractor to do the work stated.
.� i riI v
Signature of owner and/or Condo President Date i ature �' Contrac • r or Owner -B . t: er
7 --- ) C - e 7 6' - '-' ;
stima ted Cost ost v al ue ) ,/ f
Date
My Commission Expires:
Notary as to Contractor or Owner - Builder
11
No
x
7
Date
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C.C.F. • 6 0 NOTARY 5 - BOND
TOTAL DUES
APPROVED:
Zoning Building / fl ' Electrical
Mechanical Plumbing Engineering
,n °: /
J 1
10 n
n 1
1? 1
13 a
/ 1
15 9
9 � l
l7 /
/ 1
19 0
0
• t4
• 2 7
73 2
24 2
25 2
26 2
2 2
28 3
30. 3
31 �
�2.
19A V10 . 1
r7,,,T711
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SKETCH OF SURVEY:
Lot 11, Block 2, WATERSEDGE, 009'
according to the plat there-
of, as recorded in Plat Book
9 at Page 141, of the Public 0)
Records of Dade County,
Florida.
ORDER NO: 126215
F. B. NO: 1739/44
DATE: 6/18/76
SCALES SHOWN
E.
Note: . This drawing Is not valid unless
It bears embossed seal of appli-
cable surveyor.
, vier
Scale • itto zoo
SC. •BKE=SHIS b A SOCIATES,
•
Registered Land'Surveyor N 975
State of Florida
• ob
'ERR.
Pres.
Ocale 9„ 20'
HEREBY CERTIFY: That the attached "SKETCH OF SURVEY" of the above described property
is true and correct to the best of my knowledge and belief as recently surveyed and
platted under my direction,
•